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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A physiological in vivo increase of plasma free fatty acid concentration after an overnight fast was found to be accompanied by a rise of the non-protein bound estradiol fraction. A similar increase was observed after lipase activation by the i.v. injection of 500 IU heparin in 5 healthy non-fasting subjects. In vitro studies showed a direct relationship between non-protein bound estradiol and the concentration of linoleate, linolenate, and arachidonate both in undiluted serum and in Ringer's solution containing human serum albumin (45 g/liter). Moreover, the estradiol sex hormone binding globulin complex bound to a solid concanavalin A-Sepharose matrix was markedly dissociated by oleate and even more by linoleate, linolenate, or arachidonate. These results suggest that physiological diurnal elevations in plasma free fatty acids which are amplified by high fat consumption, obesity, and stress may imply major proportional increases of available estradiol, exerting a promotional effect on breast and endometrial cancer over the years.
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PMID:Free fatty acid concentrations correlated with the available fraction of estradiol in human plasma. 369

Women with endometrial cancer are often reported as being overweight. It is thus of some interest to examine a possible connection between body weight and development of cancer corporis uteri, since a positive result might be of significance in a preventive respect. A retrospective epidemiological study of 414 patients revealed a positive correlation between body weight and endometrial carcinoma. 73.4% of the patients were overweight and 55.8% were obese. The patients had a significantly greater absolute and relative weight than normal controls of corresponding age. There was a tendency for the patients to be taller than the controls. Endometrial carcinoma may have a hormonal etiology as a result of prolonged or increased estrogenic influence on the endometrium, possibly intensified by missing progesterone stimulation. As obesity contributes to an increased level of estrogen--androstenedione being converted into estrone in the fatty tissue--a hypothesis is advanced that the diet is of importance for the development of endometrial carcinoma, as dietary quantity and composition may influence the estrogen metabolism, and thus affect the endometrial mucosa.
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PMID:Relationship of premorbid state of nutrition to endometrial carcinoma. 373 41

The authors evaluated the diagnostic effectiveness of a triple specimen technique (cyto-histologic) performed by the Perma device. The incidence of endometrial hyperplasia (according to Dallenbach-Hellweg's classification) was estimated in 254 climacteric women selected from outpatients who come spontaneously to the Menopause Clinic of the Obstetrics and Gynecology Department (Bologna University). The selection criterion was the evidence of risk factors for endometrial carcinoma, climacteric bleedings (obesity, late menopause, high blood pressure, diabetes), or endometriotropic estrogen therapy in the postmenopause. Results showed that the cyto-histologic sampling is most useful for diagnosing endometrial hyperplasia and early carcinoma (diagnostic effectiveness: 89.0-93.8%). Also, endometrial hyperplasia was found to have a significant incidence in the group we examined. This incidence was highest in women with climacteric bleedings, secondly in women using high-dose estrogens, and thirdly in women with risk factors for endometrial carcinoma. When evaluating the different kinds of endometrial hyperplasia, we never found adenomatous hyperplasia in women on estrogen therapy. Affinity between histologic and cytologic classes was around 50% in endometrial hyperplasia and 100% in early carcinoma. This emphasizes that both samplings are needed to perform an accurate diagnosis.
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PMID:Cyto-histologic evaluation of the endometrium in climacteric women at risk for endometrial carcinoma. 376 24

One hundred and forty-five patients with confirmed endometrial carcinoma treated at Kumamoto University Hospital were studied from the clinicopathological point of view. As risk factors, the incidence of high age, postmenopause, atypical genital bleeding, sterility, nulliparity, diabetes mellitus, hypertension and obesity was showed to be high. These factors may be expected to assist in screening for early diagnosis by using each factor or combination of factors. As prognostic factors, we examined the relationship between stage, depth of myometrial invasion, histological grade, histological type and survival rate. The stage was shown to be a most important predicator of survival. The depth of myometrial invasion and the histological grade closely correlated with the stage. The relationship between the histological subtype, especially papillary serous carcinoma (PSC) and prognosis, was investigated in our series of studies. PSC found in an incidence of 9.4% had a relatively poor prognosis compared with endometrioid carcinoma. Its 5-year survival rate was only 30%. Because PSC has a potential for aggressive invasion and rapid metastasis as compared to endometrioid carcinoma, careful histological examination and aggressive treatment are warranted.
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PMID:[Clinical studies of 145 cases of endometrial carcinoma--analysis of prognostic factors, especially pathological types]. 377 1

Endometrial carcinoma is found more frequently in obese subjects. In this study, we evaluated the comparative risks of endometrial cancer relative to obesity indices calculated using the Brocas coefficient. From 1979 to 1983, we treated 185 patients with endometrial cancer at the Cancer Institute Hospital, Tokyo. Compared to nonobese subjects, those who exhibited an obesity index of 1.2 or more were found to have a relative risk value of 2.0 or more times that of normal subjects across all age groups. Based on these findings, it is suggested that a practical and effective preventive measure against endometrial cancer is to avoid becoming obese.
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PMID:[Epidemiological survey on the relationship between obesity and endometrial cancer]. 378 82

Endometrial carcinoma is now the most common gynecologic cancer in the United States and its incidence is increasing. Many investigators attribute this to exogenous factors over which little control has been exerted in the western world. Obesity, dietary fat content, and changing patterns of parity and lifestyle seem significant. Moreover, there appears to be an emerging virulence noted, particularly in some centers. Improved surgical staging and a better understanding of virulence factors will increase the number of patients requiring treatment to fields larger than heretofore recognized. We can expect that one third of the patients with endometrial cancer will require treatment for widespread disease or recurrent disease. Progestational treatment is useful in approximately one-third of all patients with recurrent disease. Thus, systemic nonhormonal chemotherapy must be developed if cure rates in this disease are to improve appreciably. In 1974, only 126 patients had been reported to have been treated with cytotoxic chemotherapy for endometrial cancer. Since that time, experience has demonstrated that the most active single agents are adriamycin, cisplatin, and hexamethylmelamine. These drugs produce a 30-40% response rate when used individually. Multidrug regimens employing various combinations have achieved responses of 15-85% with and without the inclusion of a progestational agent. The median duration of response has been increased but cures are still relatively few. Adverse effects are tolerable and age is not a contraindication to the administration of cytotoxic chemotherapy. Adjuvant treatment is being tested and optimism for future success is justified.
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PMID:Cytotoxic chemotherapy for patients with endometrial carcinoma. 379 31

In postmenopausal women, obesity is positively related to the risk of both breast and endometrial cancer. Additionally, obesity is associated with increased estrogen production secondary to increased peripheral aromatization. In postmenopausal women, this effect is proportionately more significant because the ovaries no longer contribute to production of estrogen. Obesity also alters the further metabolism of estrogens, resulting in products that retain estrogenic potency. Consequently, the estrogen-sensitive tissues of obese women are exposed to more stimulation than those tissues in leaner women. It is possible that this increased estrogen exposure is responsible for the augmented risk of breast and endometrial cancer observed in obesity. Evidence is accumulating that dietary macronutrients can alter the metabolism and excretion of endogenous estrogen and androgen, providing a potential mechanism by which diet can modulate the risk of hormone-sensitive cancers.
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PMID:Obesity, diet, endogenous estrogens, and the risk of hormone-sensitive cancer. 379 18

Among 30 cases of uterine body cancers, in eight cases (Stage IA, two cases; Stage IB, six cases) uterine adenomyosis was demonstrated microscopically. The age range was from 46 to 66 years with a median of 56. When these eight cases were compared with the 12 cases of Stage I endometrial cancer without adenomyosis, there was no difference in either menstrual history or family history, although past histories of hypertension and diabetes mellitus were found in these eight cases. The mean obesity index was 127 in eight cases and 116 in 12 cases. Seven of these eight cases were pure tubular adenocarcinoma. From the standpoint of early myometrial infiltration of the endometrial cancer, these eight cases not only provided a good model to survey early endometrial cancer but also suggested a common stimulus, such as estrogen, in both endometrial cancer and uterine adenomyosis.
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PMID:Clinicopathologic study of eight cases of uterine body cancers associated with endometriosis interna (uterine adenomyosis). 382 17

Estrogen treatment of climacteric women has been found to be associated with a substantially increased risk of endometrial cancer and a possible slight excess risk of breast cancer. Numerous retrospective case-control studies, reported mainly in the United States, have provided evidence of a causal link between the use of estrogens and the development of endometrial cancer. The magnitude of the risk increase has been shown to be correlated with characteristics of the exposure, chiefly the duration of treatment and the presence of certain host factors in the patient, e.g. obesity and late menopause. Cases of endometrial cancer occurring after estrogen exposure were shown to have favorable tumor characteristics and excellent survival rates. The early results from a prospective cohort study have indicated that estrogen therapy, as practised in Sweden, is associated only with an excess risk of premalignant endometrial changes and that the addition of progestogens might exert a protective effect. The risk of breast cancer after estrogen therapy has been studied in both retrospective and prospective investigations. In the majority of these studies no evidence of an increased risk has been found. However, in two case-control and two follow-up studies the risk estimates were slightly but significantly raised in association with long-term and high-dose exposure.
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PMID:The risk of endometrial and breast cancer after estrogen treatment. A review of epidemiological studies. 385 77

Early diagnosis of endometrial carcinoma enables one to achieve a cure rate of 80%. The purpose of this study is to characterize the patients who are prone to develop adenocarcinoma by simple epidemiologic and clinical data. The data of 109 consecutive patients who developed adenocarcinoma were compared with those of 146 control hysterectomy patients using logistic regression analysis. The following characteristics of patients who developed adenocarcinoma were identified: parity (P less than 0.0001), diabetes mellitus (P less than 0.003), hypertension (P less than 0.0001), obesity (P less than 0.0006), treatment with exogenous estrogen (P less than 0.001), and second primary tumor. The logistic regression formula classified correctly 77% of all patients to their actual group. The study showed that the relative risk of a patient to develop adenocarcinoma can be estimated from simple and readily available epidemiologic and clinical data.
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PMID:A novel approach to the analysis of risk factors in endometrial carcinoma. 398 36


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